Republican gubernatorial hopeful Rick Jackson is facing renewed scrutiny over his ownership of a major health care staffing conglomerate that includes a subsidiary dedicated to recruiting foreign nurses for U.S. hospitals and clinics.
Jackson Healthcare, which describes itself as the parent company to many of the healthcare industrys leading brands, purchased Florida-based Avant Healthcare Professionals in January 2018. According to the Daily Caller, Avant markets itself as a staffing firm that specializes in the international recruitment and placement of clinical professionals in the United States, positioning foreign nurses as a solution to persistent staffing shortages in American health care facilities.
Avant has a history of filing H-1B visa petitions, a nonimmigrant program that allows U.S. employers to temporarily hire foreign workers in specialty occupations requiring at least a bachelors degree. The company says it focuses on long-term placements, touting its ability to match overseas nurses with American hospitals and clinics for extended assignments that can last years rather than months.
On its website, Avant tells recruits it will guide them through every step from licensure and immigration to cultural training and job placement so you can focus on what matters most: providing the best patient care. That promise, however, became the center of a legal battle in 2023, when two foreign nurses accused the firm of exploiting immigrant labor under the guise of opportunity.
In 2023, nurses Latoya Lewis of Jamaica and Lucinda Byron of St. Thomas and the Grenadines filed a lawsuit in the U.S. District Court for the Middle District of Florida, targeting Avants use of EB-3 employment-based immigrant visas. This case is about labor trafficking and its impact on an essential workforce, including failure to pay minimum wages, suppression of wages, and unfair competition, the complaint alleged, framing the dispute as part of a broader pattern of abuse in the international nurse recruitment industry.
Lewis and Byron claimed they were paid less than American nurses performing similar work and alleged that Avant repeatedly threatened to report contract-breaching nurses to U.S. immigration authorities. They further asserted that these threats came despite assurances they would receive prevailing wages, and Lewis said Avant failed to honor a promise to help bring her daughter to the United States, according to Florida Trend.
The two nurses also contended they did not fully understand several provisions in their contracts and were pressured to sign quickly, with little time to seek independent advice, Florida Trend reported. They further alleged they were not told that their contract terms would not begin until after a month-long Avant training program, during which they said they were paid just $10 per hour before being placed in their roles Lewis in Georgia and Byron in South Dakota.
Avant led Plaintiffs and its other foreign-recruited healthcare workers to believe that they would come to the United States to practice nursing in a safe environment with a good employer who would treat them fairly, the lawsuit stated. But working for Avant was nothing like that. Rather, Avants employment is essentially indentured servitude.
The lawsuit also shed light on how international nurse recruiting firms allegedly profit from these arrangements. According to the complaint, Avant charges health care providers for the nurses work, meaning longer placements increase revenue, while early contract terminations or breaches can cut into profits and create a financial incentive to keep nurses locked into their agreements.
Initially filed in federal court, the case survived a motion to dismiss on two key claims before being transferred to state court in August in pursuit of a potential settlement, Florida Trend reported. That procedural shift opened the door to negotiations that would eventually encompass thousands of nurses recruited by Avant over the past decade.
Avant argued in court filings that nurses entering the United States on EB-3 visas are legally free to change employers once they arrive. The company maintained it had complied with the law while agreeing to a settlement framework that included up to $1 million in attorneys fees and roughly $2 million in compensation to current and former employees, with individual payouts based on specific eligibility criteria, according to the outlet.
Following months of legal maneuvering, the parties held two days of in-person negotiations and reached a proposed settlement in November. The agreement covered 5,219 nurses Avant had recruited to work in U.S. health care facilities since 2013, underscoring the scale of the firms role in importing foreign labor into the American medical system.
As part of the settlement, Avant pledged it would not seek liquidated damages or lost profits from the nurses, a key concern for workers who feared crushing financial penalties if they left early. However, the company reserved the right to recover certain contract-related costs tied to bringing the nurses into the country, such as immigration processing and relocation expenses, according to Florida Trend.
The reach of Avants recruitment network is evident in places like Johnstown, Pennsylvania, where Conemaugh Memorial Medical Center turned to employment-based immigration to fill staffing gaps. The Tribune-Democrat reported in April 2023 that the hospital brought in 31 nurses from Southeast Asia, Africa, Jamaica, Antigua and the Bahamas, all of whom obtained immigration documents including green cards through Avant Healthcare Professionals.
Many of those nurses first arrived in Florida, where they underwent cultural transition training and orientation before being dispatched to Johnstown. By mid-2022, most had reached Pennsylvania and had completed roughly eight months of their three-year contracts with Conemaugh, illustrating how long-term foreign placements can become embedded in local health care systems.
The legal and political debate around Avants practices is occurring against the backdrop of a complex U.S. visa regime. The H-1B program offers a temporary work visa for skilled positions that generally require a college degree, while the EB-3 category provides a pathway to permanent residency for skilled workers, professionals and certain unskilled laborers, making it a powerful tool for employers seeking long-term foreign staff.
Jacksons ownership of Jackson Healthcare and its Avant subsidiary now intersects directly with his bid for Georgias governorship. He is competing in the Republican primary against Georgia Lieutenant Governor Burt Jones, Secretary of State Brad Raffensperger and Attorney General Chris Carr, with voters set to cast their ballots on May 19.
Pressed on the implications of his companys foreign recruitment model, Jacksons campaign framed the issue as one of legal immigration and critical staffing needs rather than exploitation. Jacksons team told the Daily Caller, Hospitals are in desperate need of nurses, especially in rural Georgia. Avant nurses come to America legally often waiting several years learn English, pay taxes and save lives. The countrys problem is illegal immigration, and Rick Jackson will partner with the Trump administration to make Georgia the leading state for criminal deportations in America, underscoring a hardline stance on border enforcement even as his firm benefits from legal immigration channels.
The Daily Caller also contacted Jackson Healthcare directly for comment on Avants practices and the lawsuit, though the companys response beyond its court filings was not detailed in the public record. For conservative voters weighing Jacksons candidacy, the case raises a broader question: whether leveraging legal immigration to address genuine workforce shortages can be squared with a commitment to protect American workers wages and working conditions, or whether the growing reliance on foreign labor risks entrenching a two-tier system that undercuts the very communities Republicans say they aim to defend.
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